NPIMap

Organization Active NPI

Restoration Dental Group LLC

  • Dental Clinic/Center
  • Shreveport, LA
National Provider Identifier
1093035081
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3384 Issued in LA
Legal business name
RESTORATION DENTAL GROUP LLC
Practice address
2010 E 70TH St
Shreveport, LA 71105-5306
Phone
(318) 797-1181
Fax
(318) 797-1180
NPI assigned
Jun 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Raymond A Jarvis, DDSNPI 1831418318
Title
Owner of Restoration Dental Group L
Phone
(318) 797-1181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 3384 LA Primary
Dental Clinic/Center 261QD0000X 6042 LA

Addresses

Primary practice location

2010 E 70TH St
Shreveport, LA 71105-5306

Mailing address

7607 Fern Ave. Suite 800
Shreveport, LA 71105
Phone (318) 797-1181

National Provider Directory

National Provider Directory

Locations

7607 Fern Ave
Ste 800
Shreveport, LA 71105
Phone (318) 797-1181

2010 E 70th St
Shreveport, LA 71105
Phone (318) 797-1181

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1093035081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE. SUITE 800",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-797-1181",
            "fax_number": "318-797-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 E 70TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055306",
            "telephone_number": "318-797-1181",
            "fax_number": "318-797-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "JARVIS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER OF RESTORATION DENTAL GROUP L",
        "authorized_official_telephone_number": "318-797-1181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "3384",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "6042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.